The impact of splenectomy on outcomes after distal and total pancreatectomy

被引:22
作者
Koukoutsis I. [1 ]
Tamijmarane A. [1 ]
Bellagamba R. [1 ]
Bramhall S. [1 ]
Buckels J. [1 ]
Mirza D. [1 ]
机构
[1] Hepatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham
关键词
Chronic Pancreatitis; Distal Pancreatectomy; Benign Disease; Total Pancreatectomy; Cystadenocarcinoma;
D O I
10.1186/1477-7819-5-61
中图分类号
学科分类号
摘要
Background: Several authors advocate spleen preserving distal pancreatectomy, because of the increased complication rate after splenectomy. Methods: Postoperative complications and survival after distal and total pancreatectomy, were recorded and retrospectively analyzed according to spleen preservation. Patients, who underwent distal and total pancreatectomy without histologically proven adenocarcinoma, or extrapancreatic disease, were included in the cohort which was divided into splenectomy and no splenectomy groups. Statistical analysis was performed using Fisher's test. Results: The study group consisted of 62 patients who underwent distal and total pancreatectomy between 26/11/1987 to 6/1/2006. Splenectomy was performed in 35 out of 62 patients (56.5%), distal pancreatectomy was performed in 49 out of 62 patients (79%). Morbidity rate was 28.6% in splenectomy group and 14.8% in the no splenectomy group (p = 0.235), while 30 days mortality rate was 2.9%; one patient died in the splenectomy group (p = 1). Conclusion: Spleen-preservation did not influence the outcomes after distal and total pancreatectomy in our series. © 2007 Koukoutsis et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 28 条
[1]  
Balcom IV J.H., Rattner D.W., Warshaw A.L., Chang Y., Fernandez-del Castillo C., Ten years experience with 733 pancreatic resections: Changing indications, older patients, and decreasing length of hospitalization, Arch Surg, 136, pp. 391-398, (2001)
[2]  
Lillemoe K.D., Knushal S., Cameron J.L., Sohn T.A., Pitt H.A., Yeo C.J., Distal pancreatectomy: Indications and outcomes in 235 patients, Ann Surg, 229, pp. 593-598, (1999)
[3]  
Aldridge M.C., Williamson R.C., Distal pancreatectomy with and without splenectomy, Br J Surg, 78, pp. 976-979, (1991)
[4]  
Fahy B., Frey C., Hung S., Beckett L., Bold R., Morbidity, mortality, and technical factors of distal pancreatectomy, Am J Surg, 183, pp. 237-241, (2002)
[5]  
Sugo H., Mikami Y., Matsumoto F., Tsumura H., Watanabe W., Futagawa S., Comparison of ultrasonically activated scalpel versus conventional division for the pancreas in distal pancreatectomy, J Hepatobil Pancreat Surg, 8, pp. 349-352, (2001)
[6]  
Marezell A.P., Stierer M., Partial pancreaticoduodenectomy (Whipple procedure) for pancreatic malignancy: Occlusion of an non-anastomosed pancreatic stump with fibrin sealant, HPB Surg, 5, pp. 251-259, (1992)
[7]  
Suc B., Msika S., Fingerhut A., Fourtanier G., Hay J.M., Holmieres F., Sastre B., Fagniez P.L., Temporary fibrin glue occlusion of the main pancreatic duct in the prevention of intra-abdominal complications after pancreatic resection: Prospective randomized trial, Ann Surg, 237, pp. 57-65, (2003)
[8]  
Martin F.M., Rossi R.L., Munson L., ReMine S.G., Braasch J.W., Management of pancreatic fistulas, Arch Surg, 124, pp. 571-573, (1989)
[9]  
Montorsi M., Zago M., Mosca F., Capussotti L., Zotti E., Ribotta G., Fegiz G., Fissi S., Roviaro G., Peracchia A., Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: A prospective, controlled, randomized trial, Surgery, 117, pp. 26-31, (1995)
[10]  
Ziemski J.M., Rudowski W.J., Jascowiak W., Rusiniak L., Scharf R., Evaluation of the postsplenectomy complications, Surg Gynecol Obstet, 165, pp. 507-514, (1987)